Zainab and Hauwal – two fistula survivors telling their story

Kano State, Nigeria - I met Zainab Baubau, a 32-year-old fistula survivor, 19 years after the death of her son, an infant she lost during childbirth and developed an obstetric fistula.

At the age of 12, she was in labour for 48 hours, and while she waited eagerly to hear the cry of her baby, instead she heard herself crying for help. “I had prolonged obstructed labour, struggled with eclampsia, was unconscious for two weeks at the hospital and only survived to hear the sad news of my still birth and this illness.” She went on to say she felt alone because the life she knew was no longer hers.

Fistula is a condition that affects at least two millions of women worldwide, but most prevalent in developing countries. It is a childbirth complication caused by obstructed labour. It occurs when the tissues between the woman’s vagina and her pubic bone are damaged by continuous pressure from the infant’s neck trapped in the birth canal. The damaged tissue later falls off resulting in a hole through which the woman continuously leaks urine or faeces or both.

In Nigeria, an estimated 400,000 to 800,000 women are currently living with fistula and approximately 20,000 new cases occur each year. As part of the global Campaign to End Fistula, UNFPA in 2005 launched the “Fistula Fortnight” in Nigeria. It was a ground-breaking initiative that was aimed at expanding treatment options for the women and girls suffering from the condition. The initiative also supported the implementation of facility and community-based interventions to facilitate prevention of fistula and mobilize indigent women and girls to access free treatment and rehabilitation.

UNFPA has registered remarkable success in the focus areas of its fistula programming in Nigeria. It has supported free surgical repairs for Zainab and more than 6,000 women and girls living with fistula by 2016, achieving an average of 97 per cent successful repair rates to date. A total of 52 doctors and 94 nurses were trained to repair both simple and complex fistulae. In addition, comprehensive surgical equipment, including fistula repair kits, were procured and supplied to nine General Hospitals and three National Obstetric Fistula Centers throughout the country to support routine provision of fistula repair surgery. A total of more than 460 community educators and mobilizers – both women and men – were trained to provide counseling services to women living with fistula and their spouses. In addition, 40 social workers were trained to support women by providing necessary pre-and post-operative psychosocial counselling services to clients in the treatment and rehabilitation centres.

Hauwal Mohammed, a 35-year-old fistula survivor, also took part in UNFPA vocational skills acquisition and empowerment programme. At age 16, she was forced to drop out of school to marry a suitor. She lived with the condition for ten years after several failed attempt of surgical repair. She felt unworthy because everything she touched was considered dirt. “If I touch a plate they will discard it. I cried a lot,” she said. After the successful surgery, Hauwal was empowered to become economically independent and is now a proud tailor running her business. Hauwal is not the only one.

UNFPA has supported the economic rehabilitation of more than 350 successfully operated fistula survivors in addition to the social reintegration of more than 400 survivors with fistula deemed inoperable, through skills acquisition training sessions and provision of start-up kits.

Fistula is preventable, and can be avoided by delaying the age of first pregnancy; ensuring skilled birth attendance at all births and providing timely access to obstetric care for all women who develop complications during delivery. UNFPA will not stop until fistula is history in Nigeria.